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The causes behind medical billing errors (1 of 2)

If you have ever received a bill for a complicated medical procedure it likely seemed like it was written in another language with all of the codes and medical terms. The problem is that when you can’t understand your bill, you have a hard time spotting errors, which are a lot more common than you may think.

A recent article from Cleveland’s The Plain Dealer revealed that as many as 289 people can play a part in writing your medical bill, and that leaves a lot of room for error. From the intake information at the beginning of your stay to the treatment records during your stay, all of the details entered on your bill impact the amount your insurance covers and you pay.

That is what The Plain Dealer decided to take a closer look at how medical bills are assembled and what could potentially go wrong at each step of a hospital stay for a routine surgery. Here is a summary of what they found:

1. The pre-surgery phase.  At this stage, basic human error like a name misspelling or another clerical error could cause problems. The pre-admission testing presents many other opportunities for mistakes to be made and the bill to increase. For example, an X-ray mistake could end up costing a patient double to have the same test done twice.

2. The surgery phase.  Doctors and nurses must keep a record that clearly states the treatment being administered. Saying too much or too little could change the meaning of what was performed and could impact the bill. If records are incomplete, insurance companies could argue that treatment was unnecessary.

Please check back on Monday for more on this issue, including what to do if you spot a mistake on your medical bill.

Source:  The Plain Dealer “Medical Billing Errors: What can go wrong? What can you do?,” June 24, 2012